Healthcare Provider Details

I. General information

NPI: 1962272328
Provider Name (Legal Business Name): MERIDIAN ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 01/08/2024
Certification Date: 01/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

934 N MAGNOLIA AVE STE 327
ORLANDO FL
32803-3840
US

IV. Provider business mailing address

4250 ALAFAYA TRL STE 212
OVIEDO FL
32765-9424
US

V. Phone/Fax

Practice location:
  • Phone: 407-496-2192
  • Fax:
Mailing address:
  • Phone: 407-601-3615
  • Fax: 386-200-5919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LAURA JOYCE GRAY
Title or Position: OWNER
Credential:
Phone: 407-496-2192